Abstract:
In a comprehensive study conducted to determine the epidemiology of Klebsiella pneumoniae infection in four specialist health institutions in Enugu urban of Enugu State, Nigeria, a total of 564 cases were enlisted which involved 298 (52.8%) patients on admission in the hospitals, and 266 (47.2%) outpatients, aged 1 to 80 years. The study was carried out from October 2012 to March 2014. Sample collections for the study were based on the doctors’ assumption of diagnosis (from patients whose complaints were mainly suggestive of respiratory tract infection, urinary tract infection, bactereamia, meningitis, liver ascitis, diabetes and wound sepsis). Different specimens were collected from the patients (midstream urine, sputum and lung aspirates, blood, ascitic fluid, cerebrospinal fluid and wound swabs) and cultured in appropriate media. The isolates were identified by conventional methods. Extended spectrum beta-lactamase production was screened using Double Disc Synergy Test method (DDST). Plasmid elimination was done using the method of Stanisich. A total of 29 (5.1%) of Klebsiella pneumoniae was isolated from the 564 samples analysed. Urinary tract infection constituted 22 (75.9%), respiratory tract infection 4 (13.8%), wound sepsis 2 (6.9%) while bacteraemia/liver ascites was 1(3.5%). The number of male isolates were 12 (41.4%) a little bit smaller than that of female isolates 17 (58.6%). This was found not to be statistically significant (p > 0.05). The incidence of Klebsiella pneumoniae from non-hospitalized patients were 10 (34.5%), while hospitalized patients constituted 19 (65.5%) which difference was statistically significant (p<0.05). In the age group below 29 years, no Klebsiella pneumoniae was isolated from both sexes; however, from the age group of 30 years and above, individuals began to acquire the infection. A total of 12 (41.4%) of the isolates were Extended Spectrum beta lactamase (ESBL) positive. Patients who have been on antibiotic treatment for more than 2 weeks, constituted 10 (83.3%) isolates, which difference was found to be statistically significant (p<0.05). This study has shown that there is high rate of Klebsiella pneumoniae involvement in many human illnesses in the population; also the high rate of resistance to frontline antibiotics was clearly seen.
